Coding Guidance Articles

This article provides evidence-based research and coding guidance for image guided radiotherapy (IGRT) related to optical surface mapping system technologies (OSMS). Highlights research articles, presents background information for OSMS technologies, and outlines proper usage of CPT and HCPCS codes for this process.

IGRT with OSMS Guidance

ASTRO's CUAC provided a brief summary on the current and appropriate use of CPT code 77301, Intensity-modulated radiation therapy (IMRT) planning.

IMRT Planning (77301)

This MLN Matters® Special Edition Article is intended for Outpatient Prospective Payment System (OPPS) providers submitting claims for outpatient intensity-modulated radiation therapy (IMRT) planning to Medicare Administrative Contractors (MACs).

IMRT Planning Services Editing-SE18013

The Office of Inspector General (OIG) conducted an audit on Medicare payments for intensity-modulated radiation therapy (IMRT) planning services. Overpayments were discovered in the hospitals due to being unfamiliar with or misinterpreting the Centers for Medicare and Medicaid Services (CMS) guidance. In addition, the claim processing edits failed to prevent the overpayments because the edits did not address bundle payments billed on a different date of service.

OIG Report August 2018

This article is the 2020 updated Medicare Claims Processing Manual with a focus on Hospital Outpatient Prospective Payment Systems (HOPPS) with the inclusion of APC adjustments and HCPCS code reporting updates.

Medicare Claims Processing Manual, Chapter 4

This MLN Matters^® article is intended for providers and suppliers who submit claims to Medicare Administrative Contractors (MACs), including Home Health and Hospice (HH&H) MACs, for services provided to Medicare beneficiaries and which are paid under HOPPS.

HOPPS Update July 2016

ASTRO's CUAC provided detailed coding guidance for the IGRT codes during radiation therapy treatment delivery.

IGRT Guidance

ASTRO's CUAC provided this coding article that breaks down the preparing for treatment step in the 6-phase process of care in radiation oncology. It provides detailed guidance on how to properly code for clinical treatment planning and simulation for preparing for treatment.

Treatment Preparation Guidance

ASTRO's CUAC provided clarity to the add-on code +77293, respiratory management simulation. It is listed separately in addition to the code for primary procedure.

+77293 Guidance

ASTRO's CUAC provided guidance for the proper use of CPT code 77014, Computed tomography guidance for placement of radiation therapy fields. Explains how it gets reported with simulation codes 77280-77290 and 77295.

77014 Guidance

ASTRO's CUAC summarized the process of care for CPT code 57156, insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy, and additional codes associated with gynecologic applicator placement procedures.

Gynecological Brachytherapy Procedures Guidance